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�: PASCO COIJNTY, FLORIDA <br /> Permit No. Z <br /> Date Permitted / <br /> � <br /> Builder Name/Owner Name j�����y,�q���¢,�i;C��Control# <br /> County Parcel No. �`�-7�s=Z/-�180 -DGl':(��O-Z94�z, SubDiv: pY�� <br /> Address/Location �720�, � �,,,� � -�- �9� <br /> Classification/Type of Use �Lt�Lit��2 T'�dv�-� <br /> TRANSPORTATION IMPACT FEE Rate: Sq Ft Unit: l 5�I I� <br /> Exempt � Yes � No How Determined <br /> Im act Fee Amount 3 <br /> P $ J 3Z•� Zone No. Tp,Z; <br /> SCHOOL IMPACT FEE <br /> Account (056) Single-Family Detached House Amount $ <br /> (057) Mobile Home <br /> (058) Other Residential <br /> 123) Collection Fee <br /> Exempt Yes � No How Determined <br /> PARKS AND RECREATION FEE <br /> Land Account Land Credit Land Total <br /> Recreation Account Recreation Credit Recreation Total <br /> Zone TOTAL AMOUNT $Jr?3• 7� <br /> Exempt � Yes � No Haw Determined <br /> LIBRARY FEE <br /> Land Account Land Credit Land Total <br /> Facility Account FaciUty Credit Facility Total <br /> Exempt � Yes � No How Determined Total Amount �_ <br /> RESOURCE FEE ERU <br /> TOTALAMOUNT <br /> Prepared By Checked By <br /> NO CERTIFICATE OF OCCUPANCY WILL BE ISSUED OR FINAL INSPECTION <br /> PERFORMED UNTIL THE TOTAL AMOUNTS LISTED HAVE <br /> BEEN PAID AND <br /> RECEIPTED FOR BY A CENTRAL PERMITTING OFFICE OF PASCO COUNTY <br /> Acknowledgement below does not Imply acceptance of concurrence,but sfmply racelpt of a copy of this form,placing <br /> the buiiding permft owner on natice of this assessmant and the conditions of payment for same. <br /> DATE RECEIVED BY <br /> RECEIPT NO. DATE gy <br />